Delegation as experienced by nurse managers

Iranian Journal of Nursing and Midwifery Research1735-906611320100210Delegation as experienced by nurse managers109109PostDoc of Nursing(Nursing research methodlogy), Associate Professor of Education, School of Nursing and Midwifery, Isfahan university of Medical Sciences, Isfahan, Iran.St.Hezar Jarib,Instructor of Nursing, Group of Fuindamental Nursing, School of Nursing and Midwifery, Isfahan university of Medical Sciences, Assistant Professor of Nursing Education, School of Nursing and Midwifery, Isfahan university of Medical Sciences20101113   Introduction: Since it is impossible to carry out working and organizational activities effectively without trust, managers are recommended to expand trust atmosphere throughout their organizations due to its effect on all human's communication aspects and to enhance appearance of manpower talents. Delegation of authority leads to promotion of trust throughout organization and it would be the best tool in the managers' hands to prove the trust to their personnel. Therefore, it is the nurse managers' responsibility to have adequate knowledge of delegation and to apply it. Unfortunately, no comprehensive research has been carried out in this field in Iran yet, and there is an information gap in this field. The goal of this study was to determine the delegation as experienced by nurse mangers. Methods: This study was a type of phenomenological qualitative research, which was carried out in four selected subordinates of Esfahan University of Medical Sciences in March/June 2001. The sample size of this research consisted of 14 managers as the information sources from three different ranks of superior level (matron), mid-level (supervisor) and executive level (head nurse), who all underwent unstructured interviews as the data collecting technique for this study. The obtained results were analyzed using Colaizzi method. Results: Nurse managers had three forms of experiences on delegation phenomenon that were as the following: lack of authority for delegation and frustration experiences, delegation in minor affairs, and relatively full delegation with superior's sporadic unessential interference while neither of them was perfectly acquainted with this phenomenon. Managers experienced benefits in four dimensions as benefits concerning superiors, subordinates, hospitals and patients. Experienced barriers were barriers pertaining to superiors, subordinates and situation. Conclusion: In order to apply art and skill of delegation much better in nursing management, it is necessary not only for all nurse managers to get acquainted with delegation through in service education, also for nursing students as the future nurse managers to become familiar with this field in nursing faculties. Thus, the attitude of delegation could be diffused in nursing management. Of course, a change in the attitude of matrons and superiors seems to be essential in this regard. It also should be mentioned that more qualitative and quantitative researches in this field are warranted.http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/109

Iranian Journal of Nursing and Midwifery Research1735-906611320100210Current care of patients in physical confinement in psychiatry wards of hospitals affiliated with Isfahan University of Medical Sciences110110Ms of Nursing Education, Instructor of Fundamental Nursing, Group of Fundamental Nursing, School of Nursing and Midwifery, Isfahan university of Medical SciencesMs of Nursing Education, Instructor of Psychiatric Nursing,Group of Psychiatric, School of Nursing and Midwifery, Isfahan university of Medical Sciences20101113  Introduction: Increasing number of psychiatric patients as the result of present industrialized life enhances their hospitalization rate. Since patients do not like hospitalization, they find this new environment as threatening and react in destructive and aggressive behavior. Cannon believes that when patients put themselves or others in danger, physical confinement is inevitable but only if it is based on standards. If not, it can threaten the patients with restlessness, bed sore, incontinence, antisocial behavior and anger severity. Physical confinement can have the lowest emotional and physical side effects, if it is conducted based on standards. In this way, it can be a good way to control patients' aggressive behaviors. This study was conducted to investigate and compare the current care with the standard care in confined patients. Methods: This was an observational cross-section one stage study on 125 physically confined patients hospitalized in psychiatry wards of three health centers. A standard questionnaire was filled out. The collected data were analyzed by t-test. Results: The findings showed that 68.8% of the subjects were male and 52-8% of the subjects aged between 26 to 32 years. There was a significant difference between the mean score of care administrated before physical confinement, and that during confinement or in a standard condition. Conclusion: The increase in aggression is a warning sign for patients and the health team members. Given the difference between the standards and the methods administrated in hospitals, educating nurses as leaders for crisis condition in psychiatry wards concerning appropriate principles of physical confinement is essential.http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/110

Iranian Journal of Nursing and Midwifery Research1735-906611320100210Structural and process standards in emergency ward of the selected hospital of Isfahan University of Medical Sciences111111Ms of Nursing of Education, Instructor of Nursing Health, Group of Health, School of Nursing and Midwifery, Isfahan university of Medical SciencesMs of Nursing Education, Instructor of Nursing Health, Group of Health, Faculty of Nursing, Isfahan University of Medical SciencesBs of Education Nursing, Group of Operating Room, School of Nursing and Midwifery, Isfahan university of Medical Sciences20101113  Introduction: Since the nurses working in emergency ward are the first group who make early interventions to save critical patients, they have to have enough knowledge and skills in this field. Ignoring structural and process standards can results in personnel dysfunction and their low nursing services. This study tried to define the mean obedience of structural and process standards in an emergency ward of selected hospitals of Isfahan University of Medical Sciences. Methods: This was a cross-sectional descriptive analytic study. The main target of the study was to investigate the level of obedience for structural standards such as physical environment, facilities and manpower as well as process standards like patients care. First, an observation checklist for physical environment, facilities and manpower was made and the data were collected from the emergency ward personnel (nurses and nurse aids) working in the ward through direct and indirect methods. Then, the collected data were analyzed by descriptive statistics after being classified. Results: The findings of the research showed that the ward had appropriate level in 83.8% of physical environment characteristics, 75% of facilities and equipments, and 64.5% for manpower. About 46% of the personnel had excellent efficiency and 32.9% had low to average efficiency. Conclusion: According to the results, we have good manpower programs, efficient records, control tools and adequate facilities. Meanwhile, strategies of motivation and job satisfaction enhancement should be considered as wellhttp://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/111

Iranian Journal of Nursing and Midwifery Research1735-906611320100210Associations between maternal health literacy and pregnancy outcomes112112Ms of Midwifery and Assistant lecturer,PhD students, Group pf Midwifery, School of Nursing and Midwifery, Isfahan university of Medical Sciences, Isfahan, Iran, hezar jerib streetMs of Midwifery, Center of Health from City of IsfahanBs of Midwifery, Center of Medical of Beheshti Shahid of Isfahan20101113Introduction: Health literacy includes the ability to understand instructions that come from health workers and units, cognitive and social skills and the competence to use such information and services in health-enhancing ways. Antenatal care is an important key factor in maternity health. Maternal health literacy and cognitive and social skills required for maternity health include abilities to detect alarming signs and to take actions for providing healthier life style and better nutrition during pregnancy. The associations between maternal health literacy and outcome of pregnancy and birth were investigated in this study. Methods: This research was a descriptive analytic study carried out in Isfahan Beheshti Hospital in 2005. A total of 150 parturients were selected randomly in postpartum ward based on inclusion criteria. Women who were educated in medical sciences or had chronic disease and pregnancy complications were excluded. Data were collected through questionnaires and analyzed with SPSS. Results: Based on the scores they were given from the questionnaire, 34%, 48% and 18% were classified as having low, moderate and adequate maternal health literacy, respectively. Women with adequate health literacy were significantly better in having earlier and more frequent antenatal care, neonatal birth weight, mother HCT, ferrous tablet and folic acid consumption, pregnancy weight gain, gestational age at birth, method of delivery and. breastfeeding. Other birth outcomes were similar between the three groups of maternal health literacy. Conclusion: Our study had adequate power to assess meaningful difference in pregnancy outcomes among the three levels of maternal health literacy. The findings suggested that adequate health literacy among pregnant women is associated with good pregnancy outcome and poor health literacy causes poor chance to gain a positive pregnancy outcome. A collaborative effort to increase maternal health literacy by assessing maternal health literacy levels in prenatal care unit, revision of educational materials into plain language, and provision of pregnant women with oral and video instruction in addition to written materials are highly recommendedhttp://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/112

Iranian Journal of Nursing and Midwifery Research1735-906611320100210Related factors with women's body mass index in Isfahan113113Ms of Midwifery, Instructor of Midwifery, Group of Midwifery, School of Nursing and Midwifery, Isfahan university of Medical SciencesPhD of and Epidemiology and Biostatistics Associate Professor of Epidemiology and Biostatistics, Dep of Biostat, school of puplic health, Isfahan university of medical sciences20101113Introduction: Today, prevalence of overweight and obesity is increasing in most parts of the world. Obesity plays an important role in creating health poverty and decreasing life span in women. The most common formula to assess physical health is body mass index (BMI). The present research was conducted to determine related factors (personal and reproductive characteristics) in women's BMI. Methods: This was a descriptive analytic cross-sectional study. The samples were 384 people in Isfahan. They were selected by cluster sampling and referred to 10 health centers in the city. In this research, the data collecting instruments included a questionnaire, an adult standard scale and a standard meter tape. Collected data were analyzed by SPSS software through descriptive and analytic statistical methods. Results: The results showed a significant statistical relation between BMI and the following factors: age, education, family economic situation, menarche age, the number of pregnancies and deliveries, use of low dose oral contraceptives and history of deliveries with less than two years interval (P<0.05). Conclusion: Acquainting the women with the above-mentioned factors, creating a situation for women to continue their educations in different levels, training the women to limit the pregnancy and delivery numbers and preventing deliveries with less than a two year interval through mass media can be helpful to prevent overweight and obesity in women.http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/113

Iranian Journal of Nursing and Midwifery Research1735-906611320100210The effect of praying on blood pressure of women in Isfahan in 2005114114Associate Professor,Islamic Azad University Branch of TehranMs of Nursing, Group of Medical – Surgical Nursing, School of Nursing and Midwifery, Isfahan university of Medical SciencesInstructor, School of Health, Tehran University20101113  Introduction: Hypertension is one of the most important, non-contagious diseases worldwide. Every year many people either die or suffer from this chronic disease. Therefore, the first step is to screen pre-hypertensive people and change their life styles. Nowadays, praying in complementary alternative medicine is known as an important factor in changing people's lives. This study was done with the goal of defining the effects of praying on blood pressure of women in Isfahan. Methods: This study was a random controlled clinical trial. Sixty pre-hypertensive women aged 25-45 years were randomly selected. They were divided into 2 groups of intervention and non-intervention. In intervention group, they were given tapes of selected praying but in non-intervention group they were not. The data were collected by questionnaires, checklists and interviews. Results: Two groups were not identical regarding age, occupation, marital status, and educational level. The findings showed that in intervention group, mean systolic blood pressure before intervention was 132.93 mm/Hg and after that was 128.70mm.Hg (with a decrease of 4.23 mm/Hg). Diastolic mean blood pressure before intervention in intervention group was 84.82 mm/Hg and after intervention was 83.48 mm/Hg with a nearly 1 mm/Hg decrease. The differences between the mean systolic and diastolic blood pressures before intervention with the corresponding ones after intervention were significant (p<0.05). Conclusion: This research suggested the effectiveness of praying as part of complementary medicine in a non-medication way with no side effects in pre-hypertensive peoplehttp://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/114

Iranian Journal of Nursing and Midwifery Research1735-906611320100210Social health needs in high school female students115115Assistant professor of Nursing Education, Group of Health, School -of Nursing and Midwifery, Isfahan university of Medical SciencesMs of NursingInstructor of Nursing Health, Group of Health, School of Nursing and Midwifery, Isfahan university of Medical Sciences20101113 Introduction: In countries like Iran in that most of the population consists of young people, designing and implementing comprehensive health programs targeted at young people must become a priority in national programs. More than half of high school students in Isfahan are female. Because of their more vulnerability, and their roles in health of future generations, it is essential for health community to be aware of what they are experiencing on their health needs. Based on this awareness, designing and implementing accurate programs should be done in order to improve their health. This study was carried out with the aim of finding health needs of female high school students. Methods: A phenomenological qualitative approach was used and participants were chosen from the female high school students of five districts of Ministry of Education in Esfahan. Purposeful sampling was adopted in the study and the sample size composed of a total of 15 participants. Deep interviews were used through Streubert method. Results: From the findings of the interviews, 77 codes expressing participants' experiences were emerged. At the end, these codes were categorized in 3 <a href="http://themes.as/">themes as</a> the following: 1) school and school performance, 2) social security and 3) interactions with opposite sex. Conclusion: Social interactions are crucial during adolescence and have great impact on students' health. In fact, female adolescents express and define their health according to their interactions and communications with the environment.http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/115

Iranian Journal of Nursing and Midwifery Research1735-906611320100210Epidural painless delivery: a phenomenology research116116Hassan Zahraie, Ms of Midwifery Education, Group of Midwifery, School of Nursing and Midwifery, Isfahan university of Medical Sciences,Ms of MidwiferyMs of Midwifery, Group of Midwifery, School of Nursing and Midwifery, Isfahan university of Medical SciencesPostDoc of Nursing, Associate Professor of Education, School of Nursing and Midwifery, Isfahan university of Medical Sciences20101113  Introduction: Regarding the recent increase in elective cesarean, in order to increase the satisfaction of women and physicians, the Iranian government has tried to solve this problem by epidural painless delivery. Because of the opposite views of people and society on epidural painless delivery, this study was done to find mother's experience of epidural painless delivery. Methods: This was a qualitative, phenomenological study. We selected 12 pregnant women who underwent epidural painless delivery in Shabihkhani Hospital. We used convenient sampling method and in-depth interview for collection of information. Data analysis was done via Colaizzi seven-stage method. Results: Findings of these interviews were classified in 195 codes and 9 themes and 3 main concepts, including the choices of epidural painless delivery, natural delivery and using human resources and managing system. Conclusion: Mothers' good experience of epidural painless delivery led them considering this kind of delivery for the next pregnancy. This can result in decreasing the elective cesarean section rates.http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/116